Nicole L. Miller, MD, FACS, presented “Surgical BPH: 2024 Updates and Where Are We Going” during the 2024 Frontiers in Oncologic Prostate Care and Ablative Local Therapy symposium on October 17, 2024, in San Diego, California.
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How to cite: Miller, Nicole L. “Surgical BPH: 2024 Updates and Where Are We Going.” October, 2024. Accessed Jan 2025. https://grandroundsinurology.com/surgical-bph-2024-updates-and-where-are-we-going/
Surgical BPH: 2024 Updates and Where Are We Going – Summary
Nicole L. Miller, MD, FACS, delivers an incisive update on the surgical management of benign prostatic hyperplasia (BPH). In this 11-minute presentation, Dr. Miller outlines the current AUA guidelines, highlighting a broad spectrum of treatments tailored to prostate size. Trends in national data reveal that transurethral resection of the prostate (TURP) remains the dominant procedure, while minimally invasive options like UroLift have gained substantial traction.
Dr. Miller discusses emerging technologies, including the OptilumeⓇ BPH System. She also reviews promising data on MRI-guided transurethral ultrasound ablation (TULSA). Advanced laser techniques, particularly holmium pulse modulation, and thulium fiber laser, are explored for their efficacy in enucleation procedures, showing advantages in operative time, hemostasis, and same-day discharge rates. Miller highlights evolving techniques like en bloc enucleation with early apical release. A brief discussion on robotic-assisted simple prostatectomy includes recent shifts toward single-port approaches.
Dr. Miller stresses the importance of aligning treatment with patient preferences and quality-of-life goals, emphasizing shared decision-making as central to optimizing outcomes in this rapidly advancing field.
Frontiers in Oncologic Prostate Care and Ablative Local Therapy (FOCAL) is an outstanding program on prostate imaging, transperineal interventions, and ablative treatments for prostate cancer and benign prostatic hyperplasia. Bringing together community-based, academic, and industry partners, FOCAL offers lectures by world-renowned faculty and hands-on training workshops on in-office transperineal interventions, fusion-guided prostate ablation and state-of-the-art BPH management with novel technologies.
ABOUT THE AUTHOR
Nicole L. Miller, MD, FACS, is an Associate Professor of Urology at Vanderbilt University Medical Center, where she is also on faculty for Vanderbilt’s Fellowship in Endourology and Laparoscopic Surgery. A graduate of the University of Pittsburgh School of Medicine, she received her urology residency training at the University of Virginia Health Sciences Center before completing a two-year fellowship in Endourology and Minimally Invasive Surgery at Indiana University School of Medicine. Dr. Miller’s specialties include medical and surgical treatment of kidney stone disease and BPH. Her research interests include the changing composition of renal calculi, the pathophysiology and etiologies of nephrolithiasis, and antibiotic selection for kidney stone treatment. Dr. Miller’s work has been published in the Journal of Urology, Urolithiasis, and the Journal of Endourology, among others.
